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Work Life Balance and Job Satisfaction: A comparative study of

Doctors in Government and Private Hospitals

Introduction

An organization needs to attract and retain valued employees in a highly

competitive labour market is a strong motivating factor for increased

organizational awareness and action with regard to human resource policies and

practices that address work life balance. Work life balance is an important area

of human resource management that is receiving increasing attention from

government, researchers, management and employee representatives and the

popular media ( Pocock, Van Wanrooy, Strazzare and Bridge, 2001; Russell and

Bowman, 2000).

In 1986, work-life balance was first used to describe the trend of individuals

spending more time on work and less time on other aspects of their lives

(Lockwood, 2003). The term ‘Work Life Balance’ has been used to describe the

balance between an individual’s work and personal life and feeling comfortable

with both work and non work commitments. Early interest in work life balance

was driven by the erosion of the ‘male bread winner model’, due to increased

entry of women in the labor market. Since the second half of 20th century the

nature of work has changed and concerns regarding quality of life are increasing

which has made work life balance a hot topic of research among the policy

makers and researchers.

Work-life balance has been defined differently by different scholars. In order to

broaden our perspectives, some definitions are presented. Greenhaus (2002)

defined work –life balance as satisfaction and good functioning at work and at

home with a minimum of role conflict. Felstead et al. (2002) defines work-life

balance as the relationship between the institutional and cultural times and

spaces of work and non-work in societies where income is predominantly

generated and distributed through labor markets. Aycan et al. (2007) confined

the subject only with work and family and put forward the concept of “life

balance” with a more whole perspective. Clark (2000) defines balance as

“satisfaction and good functioning at work and at home with a minimum of role

conflict”.

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According to Fisher (2001) work life balance, includes both work/personal life

interference as well as work/personal life enhancement and gives three

dimensions of work life balance, i.e.,

• Work interference with personal life

• Personal life interference with work

• Work/Personal life enhancement

The following are working definitions of terms used regarding work/life

balance:

� Work/family: A term more frequently used in the past than today. The

current trend is to use title that include the phrase work/life, giving a

broader work/life connotation or labeling referring to specific areas of

support (e.g., quality of life, flexible work options, life balance, etc.)

� Work/life conflict: The push and pull between work and non work

responsibilities.

� Work/life balance from the employee viewpoint: The dilemma of

managing work obligations and personal/family responsibilities.

� Work/life balance from the employer viewpoint: The challenge of

creating a supportive company culture where employees can focus on

their jobs while at work.

� Family-friendly benefits: Benefits that offer employees the latitude to

address their personal and family commitments, while at the same time

not compromising their work responsibilities.

� Work/life programs: Programs (often financial or time-related)

established by an employer that offer employees options to address work

and personal responsibilities.

� Work/life initiatives: Policies and procedures established by an

organization with the goal to enable employees to get their jobs done and

at the same time provide flexibility to handle personal/ family concerns.

� Work/life culture: The extent to which an organization’s culture

acknowledges and respects the family responsibilities and obligations of

its employees and encourages management and employees to work

together to meet their personal and work needs.

Work life balance refers to the effective management of multiple

responsibilities at work, at home, and in the other aspects of life. It is an issue

that is important both to the organizations and to employees. Work life balance

are the employee feelings that they are freely able to use flexible work hours

program to balance their work and other commitments like, family, hobbies, art,

travelling, studies and so forth, instead of only focusing on work. This shows

that provision of good work - life balance leads to the activities that lead to

satisfaction of employees and make them a good contributor in the

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organizational performance. Good work life balance is defined as a situation in

which workers feel that they are capable of balancing their work and non - work

commitment. Improving the quality of work life balance facilities not only helps

in improving the productivity but also helps in increasing employee loyalty and

job satisfaction. Work life balance has important consequences for employee

attitudes towards their organizations as well as for the lives of employees. The

belief that organization cares about employee well being has a positive impact

both for employee and the employers, that are employee satisfaction, and the

organizational commitment and intention to remain with the organization.

The study of work-life balance includes an insight into the factors which

contribute to a proper Work Life Balance, the relationship between Work Life

Balance and job satisfaction, stress and Work Life Balance, benefits of an

effective Work Life Balance, the policies adopted by organizations towards

balancing work and personal life and the awareness and preference of

employees towards it. The positive effect of proper Work Life Balance are

motivation towards work, positive job satisfaction, improving employee morale

and productivity, enough time for personal and family life, improved health

condition etc. The negative effect of an imbalance in work life is associated

with a myriad of indicators such as job stress, work-life conflicts, absenteeism,

high attrition rate, burnouts, job switching , work alcoholism, health issues etc.

When the work-life balance is not achieved, the concept of work-family conflict

is raised, which describes a type of interrole conflict, wherein at least some

work and family responsibilities are not compatible and have a resultant effects

on each domain (Greenhaus & Beutell, 1985). This conflict could possibly

impact productivity, turnover, satisfaction, motivation, morale, and

organizational commitment of employees.

Work life balance of an employee is influenced by individual related variables,

work related variables and family related variables. Individual related variables

include gender, age, marital status, emotional intelligence, etc. Work related

variables include task variety, task autonomy, task complexity, role conflict,

work schedule flexibility, number of hours worked etc. Family related variable

include spouse support, spouse work hours, couple’s employment status,

number of children, parental responsibilities, home responsibilities etc.

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The consequences of employee work-life imbalance

Previous research studies show that work life imbalance results in grave

consequences for employers, employees and organization. Personal and societal

consequences of work-life imbalance, according to Hobson, Delunas and Kesic

(2001) include:

� Increased level of stress and stress-related illness.

� Lower-life satisfaction.

� Higher rates of family strife, violence, and divorce.

� Rising incidence of substance abuse.

� Growing problems with parenting and supervision of children and

adolescents.

� Escalating rates of juvenile delinquency and violence.

The continuous inability of employees to balance work and life responsibilities

according to Hobson, Delunas and Kesic (2001) can have the following

organizational consequences:

� Higher rates of absenteeism and turnover.

� Reduced productivity.

� Decreased job satisfaction.

� Lower levels of organizational commitment and loyalty.

� Rising healthcare cost.

The benefits of work-life balance

Positive work-life outcomes for employees are key ingredients of a successful

business strategy. Where the right balance is found and sustained, both the

employee and the employer gains.

Benefits for the employee :

Many factors improve where the employee is able to find the right balance.

Some of these factors, according to Vlems (2005) include:

� Imcreased employees happiness: Employees would be happier when

they are able to balance their work and life demands.

� Improved relations with management: Perceived support of

management towards employees work-life balance fosters a good

relationship between the workforce and management which itself

improves effective communication within the company.

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� Improved employee’s self-esteem, health, concentration, and confidence.

� Employee loyalty and commitment: These increases with opportunities

for work-life balance. Employees are more likely to stay with an

organization when there are opportunities for achieving work-life

balance.

� Tasks are managed better, increased motivation, and reduction in the

level of stress among employees.

Benefits for the employer

Generally, the following factors, as Vlems (2005) notes, improve for the

employer:

� Maximized available labour: The workforce will be very motivated and

so the employer can benefit from maximized available labour. Every

employee will give their very best during the working hours.

� The balance makes employees feel valuable: Implementing work-life

balance programmes gives an impression that the organization cares

about the employees. Thus, they will feel more valuable and work harder

as a result.

� The work environment will be less stressful: Which means less stress

related illnesses and decreased health care costs.

� Employer of choice: The presence of work-life balance programmes in

an organization makes it attractive to a wider range of candidates when it

comes to recruitment.

� Increased loyalty and decreased absenteeism: The workforce will be

more loyal and motivated, absenteeism will be reduced and productivity

of the organization will increase.

Work Life Balance Options

Work-life balance programmes (WLBPs) are those institutionalised and

procedural arrangements, as well as formal and informal practices that make it

easier for employees to manage the often conflicting worlds of work and non-

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work. Work-life balance initiatives designed to help employees balance their

work and personal lives are not only an option, but also a necessity for many

employers today. There is a need for organizations to adopt human resource

strategies and policies that accommodate the work-life needs of a diverse

workforce in the current business environment. As Vlems (2005) notes, when

organizations decide to facilitate their employees’ work-life balance, they

choose from a wide array of options that include:

(a) Flexi-time

Flexi-time is a scheduling policy that allows full-time employees to choose

starting and ending times within guidelines specified by the organization. It

works well for full-time office staff, but not in shift patterns or in a production

line. Flexi-time allows an employee to attend to non-work demands without

having to take time off work.

(b) Compressed working hours

This is a system of a four day working week. An employee can work his total

number of agreed hours over a shorter period. For example, an employee can

work his or her hours over four days in a week instead of five, and thus, gains a

day for himself.

(c) Job-sharing

Job-sharing is a system where two people share a job. They both have the same

job, but split the hours, so that each employee has a part-time position. Apart

from splitting the hours, they also split the payments, holidays and benefits. The

idea is to afford employees ample time to attend to non-work activities so as to

be able to achieve a good measure of work-life balance.

(d) Breaks from work

By taking breaks from work once in a while, the right balance between work

and life can be achieved. These breaks should not only be about maternity,

paternity and parental leave, but also time off for career breaks and sabbaticals.

(e) Self-rostering

Employees can roster their hours the way they want to. The organization checks

every day the number of staff and skills required and lets the employees then

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decide which of hours they would like to work. Employees are thus able to

schedule their time conveniently between work and non-work activities.

(f) Teleworking

Employees, with the aid of modern communication technology carry out their

jobs without necessarily having to be at the office. Often, they can work from

home or in satellite offices (telecentres) rented by the organization close to

where they live. Teleworking allows employees to attend to family or non-work

issues so long as it does not affect their output or the quality.

(g) Child care

People with families do not have the luxury to stay at home anymore and take

care of the children. The trend is towards dual-earning families as life has

become too expensive to let a potential money-maker stay at home. Thus, the

demand for child care options as a means of helping employees achieve work-

life balance is becoming increasingly important (Vlems, 2005). Some popular

child care options include Crèche, Day-nursery, after school child care etc.

Job Satisfaction

Job satisfaction is the most studied variable in organizational research (Spector,

1997). The most-used research definition of job satisfaction is by Locke (1976),

who defined it as “a pleasurable or positive emotional state resulting from the

appraisal of one’s job or job experiences”. Balzer, et al. (1997) defines job

satisfaction as the feelings a worker has about his or her job experiences in

relation to previous experiences, current expectations, or available alternatives.

Job satisfaction is simply how people feel about their jobs and different aspects

of their jobs.

The attitude and feelings of the people towards their work has a direct bearing

and reference to ‘job satisfaction’. Positive attitude towards the job signifies job

satisfaction and vice versa. Job satisfaction does not depend on any particular

aspect of the job. The level of job satisfaction is affected by intrinsic and

extrinsic factors, the quality of supervision, social relationships with the

work groups and the degree to which individuals succeed or fail in their work.

It also refers to the extent to which an individual’s needs are satisfied. Job

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satisfaction can be influenced by variety of factors. Opkara (2002) described

that “factors such as pay, the work itself, supervision, relationships with co-

workers and opportunities for promotions have been found to contribute to job

satisfaction.” Working hours and nature of work both are the primary

contributors to job satisfaction. Flexibility in schedule of work is important for

job satisfaction as flexible time table and shorter hours of work allow

employees to balance work and family life better.

Similar to European and western countries, India has witnessed several changes

in the work force demographics, like rising number of women(Census of India,

2001), escalating number of dual income families and nuclear families (Bharat,

2003; Buddhapriya, 2009). These rapid transitions have put substantial strain on

men and women to balance their work-life and family-life. How individuals can

be successful in their working lives without sacrificing their personal lives is a

debatable issue (Lewis and Cooper, 2005). As a result of intensification of work

demands, there seems to be a continuous focus on work-life balance.

The debate on the issues of job satisfaction has been in discussion for a long

time but its relationship with Work Life Balance (WLB) gained importance in

the recent past. Providing Work Life Balance facility creates a cooperative

atmosphere between the employer and the employee. Nowadays, the studies of

job satisfaction and work life balance go hand in hand. Previous researches have

indicated that organizations which provide various work life balance practices

to their employees experience improved productivity and reduced turnover.

Employees of such organizations are motivated and satisfied with their personal

and professional life.

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Review of Literature

Review of related literature is an important step in undertaking research. It helps

in clarifying and defining the problem, stating objectives, formulating

hypotheses, selecting appropriate design and methodology of research as well as

interpreting the results in the light of the research work already undertaken. In

this chapter, an endeavor has been made to provide an overview of various

aspects of work life balance through the review of existing literature. The

sources referred include various journals, books, doctoral thesis, working

papers, reports, magazines related to human resource, internet sites, newspapers

etc.

Greenhaus and Beutell (1985) in the paper titled “Sources of conflict between

work and family roles” defined work-family conflict as a form of inter-role

conflict in which the role pressures from the two domains, that is work and

family, are mutually non-compatible so that meeting demands in one domain

makes it difficult to meet demands in the other’. That is, participation in the

work role is made more difficult by virtue of participation in the family and

vice-versa.

Thompson, Beauvais, and Lyness (1999) in their paper titled “When work-

family benefits are not enough: The influence of work-family culture on

benefit utilization, organizational attachment and work-family conflict”

considered the links between an organization’s work/family culture, and the

extent to which employees used work/life benefits, the extent of work/family

conflict, and the employees’ intention to stay with their company. The study

revealed that more work/family benefits translated to greater commitment, less

work/family conflict, and less intention to leave.

Clutterbuck David, (2003), in his book titled “Managing Work Life Balance:

A guide for HR in achieving organizational and individual change” revealed

that Work-life balance is one of the most important issues facing employers and

managers today. Employees at all levels are no longer willing to trade their

quality of life in order to get a decent standard of living. Managers can no

longer afford to ignore the costs that the long-hours culture imposes on their

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organization. Overwork causes stress-related absenteeism, poor retention levels,

low creativity, appalling customer service and unethical employee behavior.

Kothari, (2004), in his book titled “Research Methodology: Methods and

Techniques” aims to make researchers familiar with the art of using different

research methods and techniques. The book consists of fourteen chapters

comprising of defining the research problem, research designs, sampling

designs etc.

Penneerselvam R., (2004), in his book titled “Research Methodology” gives in

depth coverage of concepts and techniques of Research Methodology. It begins

with an overview of research methodology followed by fifteen chapters: data

collection and presentation, review of basic statistical measures, design and

analysis of experiments, attitude measurement and scales, probability

distribution, sampling methods etc.

Pryce, Albertsen, Nielsen, (2006), in the paper titled ‘Evaluation of an open-

rota system in a Danish psychiatric hospital: a mechanism for improving job

satisfaction and work–life balance’ tried to evaluate the impact of an open-rota

scheduling system on the health, work-life balance and job satisfaction of nurses

working in a psychiatric ward in Denmark. Nurses in the intervention group as

compared to those in the control group were reported to be more satisfied with

their work hours, were less likely to swap their shifts, reported a significant

increase in work–life balance, job satisfaction, social support and ratings of

community spirit.

Bratton and Gold, (2007), in their book titled ‘Human resource management,

Theory and Practice’ endeavored to make the field of HRM more transparent

and relevant by analyzing HRM theory and practice as a part of management

process. The book reveals that if researchers and HR practitioners wish to

demonstrate the contribution of HRM to organizational performance, there is a

need for more case study research that takes account of the societal effects on

HR practices as they are transplanted around the globe and translated locally

into workable social relations.

Kalliath, Thomas; Brough, Paula, (2008), in the paper titled ‘Work-Life

Balance: A Review of the Meaning of the Balance Construct’ examined six

conceptualizations of work life balance found in literature: multiple roles,

satisfaction between multiple roles, equity across multiple roles, fulfillment of

role salience between multiple roles, conflict and facilitation and perceived

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control between multiple roles. The study reveals that assessment of work life

balance should include two points:1. Weather an individual prefers to spend

more or less time on work and non work activities. 2. Weather balance leads to

growth in work and non work domains.

Cohen Aaron and Liani Efrat, (2009), in the paper titled ‘Work-Family

conflict among female employees in Israeli hospitals’ examined how demands

of work impact the family (WFC) and how demands of family life impinge on

workplace(FWC). The findings of the study supported the main conclusion of

Byron’s (2005) meta-analysis that work variables are more important

determinants of the work family conflict and family work conflict than non-

work variables.

Thanacoody P. Rani, Bartram Timothy, Gian Casimir, (2009), in the paper

titled ‘The Effects of Burnout and Supervisory Social Support on the

Relationship between Work-Family Conflict and Intention to Leave: A Study

of Australian Cancer Workers’ tried to evaluate the effect of burnout and

supervisory social support on the relationship between work-family conflict,

and intention to leave of cancer workers in an Australian health care setting.

The study reveals that burnout mediates the relationship between work-family

conflict (i.e., work-in-family conflict and family-in-work) and intention to leave

the organization and that the mediation framework is stronger in the presence of

higher social supervisory support.

Lazar Ioan, Codruta Osoian, Patricia Ratiu, (2010), in the paper titled ‘The

Role of Work-Life Balance Practices in order to Improve Organizational

Performance’ tried to identify weather work life balance initiatives and

practices can be considered as strategic human resource management decisions

that can result into improved individual and organizational performance.

Benefits to organization include reduced turnover and absenteeism and hence,

lower recruitment and training cost, improved productivity and employee

loyalty and enhanced organizational image.

Malik Muhammad Imran, Gomez Solomon Fernando, Ahmad Mehboob,

Saif Muhammad Iqbal, (2010), in the paper titled ‘Examining The

Relationship Of Work Life Balance, Job Satisfaction And Turnover In

Pakistan’ examined the effect of work life balance and job satisfaction on the

turnover intentions of doctors. The key findings reveal that doctors who are able

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to balance their work and life activities in better way are more satisfied with

their jobs and have less intention to leave the organization.

Malik, Zaheer, Khan, (2010), in the paper titled ‘Developing and Testing a

Model of Burnout at Work and Turnover Intensions among Doctors in

Pakistan’ tried to evaluate the impact of Burnout at work, work life balance,

work life conflict and job satisfaction on turnover intensions among doctors in

Pakistan. The findings of the study reveal that there is no significant effect of

burnout at work on doctors work life balance whereas it has significant effect on

the work life conflict and job satisfaction of doctors. From the study it can be

concluded that more the doctor felt burnt out at work more will be the conflict

in managing work and life activities and results in job dissatisfaction.

Newth David, (2011), in his book titled “Stress and Work/ life Balance:

Insights for manager” has identified that managers vulnerability to stress can

be lessened by them standing back from the coal face occasionally and

recognizing they have choices in how they feel in themselves and behave

towards others. The book provides potential for managers to improve or master

better control of their lives and the potential to become more effective at work

and more content at home.

Baral R., Bhargava S., (2011), in the paper titled ‘HR interventions for work

life balance: evidences from organizations in India’ examined that the socio

demographic, technological and economic changes have forced organizations to

implement family friendly policies. The study reveals that Hr managers in

emerging organizations like BPOs, health care services, software services

should implement various work life balance programs.

Choudhary Lata, Academic Director, ICMT Jodhpur, (2011), in the paper

titled ‘Work Life Balance Problems and Solutions’ identified that increasing

work pressures, globalization and technological advancement has made work

life balance an issue with both the genders, all professionals working across all

levels and all industries throughout the world.

Gunavathy, J.S., (2011), in the paper titled ‘Work-Life Balance Interventions

Prevalent in the Indian Industry’ examined the results of the study on

organizational policies and provisions regarding work-life balance of the

employees, which was carried out among a cross-section of leading corporate

entities (N = 30) in Chennai representing equally the three industrial sectors,

namely, manufacturing, information technology and services. Factors impeding

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work life balance of employees were identified as extended work hours, work

intensification, poor boundary management by the individuals, personal

constraints etc.

Rajan, Bellare, (2011), in the paper titled ‘Work related stress and its

anticipated solutions among post-graduate medical resident doctors: A cross-

sectional survey conducted at a tertiary municipal hospital in Mumbai, India’

tried to study the prevalence of work-related stress and its anticipated solutions

among the resident doctors registered for postgraduate studies in clinical

subjects at a tertiary Municipal hospital. The study reveals that highest

perceived stresses were caused by inadequate hostel/quarter facilities and the

need to perform extra duties other than the routine work assigned to them.

Friends and family rank high as stress reliever along with good music, reading a

good book and regular physical exercise.

Baba Ifrana, (2012), in the paper titled ‘Workplace Stress among Doctors in

Government Hospitals: An Empirical Study’ identified the causes of role stress

in doctors working in government hospitals and identified the levels of stress

among Male and Female doctors. The study reveals that heavy workload, time

pressure, poor administration, work/home conflict, work during nights at least

twice a week, patient’s expectations and emergencies, are the major contributors

of organizational role stress among doctors.

K.Sathana Lakshmi, Ramachandran T., and Boohene David, (2012), in the

paper titled ‘Analysis of Work Life Balance of Female Nurses in Hospitals-

Comparative Study between Government and Private Hospital in Chennai,

T.N. India’ tried to study the work life balance of female nurses in government

and private hospital and the factors that determine work life balance. The study

shows that there is no difference in stress and satisfaction related factors of

nurses working in govt. and private hospitals. Proper work life balance will lead

to retention of skilled nurses, increased productivity, and more efficient delivery

of health care services.

Revathy and Geetha, (2013), in their book titled “Career Women and Work

Life Balance” identified the important factors which affect the Work Life

Balance of women professions. This work attempts to identify the various

factors which help to maintain work life balance among women employees and

provide some recommendations to human resource professionals to deal with

work life issues of women professionals.

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Chandrasekar K.S., Suma S.R, Nair Renjini S., Anu S.R, (2013), in the

paper titled ‘Study on Work Life Balance among the Executives in IT Industry

with Special Reference to Technopark, Trivandrum, Kerala’ examined the

work life balance of employees of IT organizations in Techno Park,

Trivandrum. The major findings of the study show that there is problem of

work life balance in IT industry, work life balance varies with gender and nature

of jobs and it has positive relation with job satisfaction. The study confirms that

proper work life balance will provide job satisfaction and in turn will create

organizational success and develop competitive advantage for IT organizations.

Gupta Vinshi, (2013), in the paper titled ‘Constructs of Quality of Work Life:

An Empirical Evidence From Indian Hospitals’, tried to examine the

employees of all the departments in selected hospitals in order to understand

their point of view with respect to Quality of Work life. From the study it could

be concluded that employees of the various departments of hospitals find it hard

to balance their work life and family matters and also find the work load to be

high.

Yadav, Dabhade, (2013), in the paper titled ‘Work life balance amongst the

working women in public sector banks – a case study of State Bank of India’

examined the working environment of public sector banks for women

employees and what is the perception of women about the initiative and policies

of banks and effects of those initiatives on their lives. The study reveals that

there can be many factors affecting the balance of work and life, which may be

social factors, psychological factors, working Environment, type of job, job

satisfaction, family background, schedule at home and life stage.

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Relevance of study

In India healthcare is delivered through both the public hospitals and private

hospitals. An estimated 60% of hospitals and 80% of qualified doctors are in the

private sector. Hospitals in India are facing challenges like declining quality of

patient care, rising costs, shortage of skilled health care professionals coupled

with extremely high level of stress and burnout among doctors and nurses.

Doctors are an integral part of the hospitals providing health care services.

According to a report published by Pricewaterhousecoopers, India’s healthcare

infrastructure is inadequate to meet the huge burden of disease. India has just 90

beds per 100,000 population against a world average of 270 beds. India also has

just 60 doctors per 100,000 population and 130 nurses per 100,000 population

against world averages of 140 and 280 respectively. Public spending on

healthcare has also been less than 1% of GDP since independence.

A study by Madan N. (2008) shows that one of every three doctor is

dissatisfied due to lack of time for themselves or their families. A study by

Choudhary et al. (2004) shows that doctors have,

� 8.6% higher risk of emotional exhaustion, 10% higher risk of burnout.

� 69.5% doctors satisfied in AIIMS.*

� Medical doctor in armed force- 40% satisfied with their job.

Review of literature shows that doctors have difficulty in balancing their

professional and personal lives. It has been observed that intrusion of work into

private life of doctors has a substantial impact on work-related attitudes, and

work-life boundary variables affect the relationship of other variables like job

satisfaction and organizational commitment. Work life balance of doctors

working in hospitals is influenced by heavy work load, working under schedule

pressure, night shifts, administrative burdens, long working hours etc.

The quality of medical care provided to the patients is largely dependent on

doctor’s job satisfaction. The working conditions of doctors play important role

while over work and extended working hours are other reasons that affect

doctor’s level of job satisfaction. Research has demonstrated that job

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satisfaction of doctors working in hospitals is influenced by factors such as

heavy workload, time pressure, poor administration, work/home conflict, work

during nights at least twice a week, patient’s expectations and emergencies,

relationships with patients, prestige, quality of life, work control and balance,

income, relationships with colleagues, family issues, personal growth, ability to

provide quality care.

Lack of work life balance among doctors is associated with a variety of negative

consequences for both individuals and hospitals in which they are employed.

Work life balance also influences job satisfaction of doctors which in turn

affects the quality of patient care, absenteeism, turnover and performance and

productivity of the organization.

Though the issue of work life balance is being widely discussed in United

Kingdom, USA, Australia, New Zealand and other countries of the world, yet in

India, not much research has been done and it is not very easy to find reference

to work life balance polices and issues. Desai (2003) remarked that “there exists

little formal research in India’s work family field and few organizations in the

country have family friendly policies, such as flexi time etc. …” Most of the

studies have been carried out with a focus on various issues and dimensions of

personnel administration, HR policies and practices, HR strategies, etc. But

there are very few studies with regard to Work life Balance.

Majority of research on work life balance in India has been conducted in IT,

BPO industry, call centers and among nurses. Given the noticeable lack of

studies addressing work life balance and its impact on job satisfaction among

doctors of public and private hospitals, this study will attempt to address this

gap in the literature. As against this backdrop, zeal to study the work life

balance and job satisfaction of doctors working in selected public and private

hospitals of northern India inspired the researcher to undertake the study. Work

life balance and job satisfaction of doctors working in public and private

hospitals are of paramount importance for the betterment of doctors personal

and professional life, quality of patient care and hospital’s performance and

productivity. The purpose of this study is to compare the respective Work life

balance and job satisfaction of doctors working in government hospitals with

those working in private hospitals of three cities namely Delhi, Jaipur and

Lucknow.

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The study will be an attempt to identify the difference in the level of work life

balance and job satisfaction among doctors working in selected government and

private hospitals of Delhi, Jaipur and Lucknow. The study will also determine

the relationship between work life balance and job satisfaction of doctors and

will identify the impact of demographic factors such as age, gender and marital

status on work life balance and job satisfaction of doctors. The study will also

determine the work life balance policies, practices and procedures offered by

hospitals and will suggest specific recommendations for the betterment of the

same.

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Research Methodology

Research methodology is a science of studying how research is done

scientifically. Designing of a suitable methodology and selection of effective

analytical tools are important for a meaningful analysis of any research

problem. In it we study the various steps that all generally adopted by a

researcher in studying his research problem along with the logic behind them.

A. Objectives

Objectives of the study are as follows:

1. To study the dimensions of work life balance among doctors working in

government and private hospitals.

2. To examine the level of job satisfaction among doctors working in

government and private hospitals.

3. To identify procedures, practices and facilities offered by government and

private hospitals with reference to work life balance.

4. To compare the level of work life balance and job satisfaction between

doctors working in selected government and private hospitals.

5. To determine the relationship between work life balance and job

satisfaction.

6. To find out if there are differences in the level of work life balance and

job satisfaction caused by demographic factors such as age, gender and

marital status.

B. Hypotheses

Hypotheses of the study are as follows:

1. H1: There is a significant difference in the level of work life balance

among doctors working in government and private hospitals.

2. H2: There is a significant difference in the level of job satisfaction among

doctors working in government and private hospitals.

3. H3: There is a significant relationship between work life balance and job

satisfaction.

4. H4: There is a significant difference in the level of work life balance and

job satisfaction caused by demographic factors such as age, gender,

marital status.

21

C. Research Design

In this study descriptive research procedure will be used to study the

work life balance and job satisfaction of doctors working in selected

government and private hospitals.

D. Sample design

A sample design is a definite plan for obtaining a sample from a given

population. It includes:

Universe

The Universe of the study comprises of three cities namely Delhi, Jaipur

and Lucknow.

Sampling unit

Sample will be collected from among the doctors working in selected

Government and Private Hospitals of Delhi, Jaipur and Lucknow. List of

Government and Private Hospitals that will be included in the study is as

follows:

List of Government and Private Hospitals included in the study

S.No City Government Hospital Private Hospital

1. Jaipur 1. Sawai Man Singh Hospital

and Medical college.

2. Zanana Hospital.

3. Chest and TB Hospital.

1. Mahatma Gandhi Hospital.

2. Jaipur Hospital.

3. Santokba Durlabhji

Memorial Hospital and

Medical Research Institute.

2. Delhi 1. Safdargung Hospital.

2. Guru Gobind Singh hospital.

1. MAX Med Centre.

2. Sir Ganga Ram Hospital.

3. Lucknow 1. Gandhi Memorial Hospital

(KGMC).

2. Ram Manohar Lohia

Combined Hospital.

3. Sanjay Gandhi Post

Graduate Institute of

Medical Sciences. (SGPGI).

4. Balrampur Hospital.

1. Sahara Hospital.

2. Mayo Hospital.

22

Sampling Procedure

A probability sampling technique i.e stratified sampling will be employed

with a purpose to select a sample of doctors working in selected government

and private Hospitals of Delhi, Jaipur and Lucknow.

Sample size

The sample size of 300 doctors working in selected Government and

Private Hospitals of Delhi, Jaipur and Lucknow will be taken for the study. 125

doctors from government hospitals and 125 doctors from private hospitals will

be taken.

E. Scope of the study:

The study is confined to selected government and private hospitals of

Delhi, Jaipur and Lucknow. But the future scope of the study can be expanded

to the other regions of India or other states also.

F. Significance of the study:

Work life balance of doctors working in Government and Private Hospitals is of

crucial importance for establishing and sustaining a productive work culture.

The significance of the study is as follows:

1. The study will help the researcher to increase her knowledge regarding

the level of work life balance and job satisfaction among doctors

working in hospitals.

2. The study will help the hospitals to plan and promote various work life

balance programs to enhance job satisfaction of doctors and productivity

of the organization.

3. The present study will help to identify the level of work life balance

among doctors and will also determine the differences in work life

balance of doctors working in government and private hospitals.

4. The study will help to determine the level of job satisfaction among

doctors and will also help to find out differences in job satisfaction of

doctors working in government and private hospitals.

23

5. The study will help to find out the relationship between work life balance

and job satisfaction.

6. The study will also help to identify the impact of demographics on work

life balance and job satisfaction of doctors.

7. Hence, the study of work life balance will thus, help in better

understanding of the issue of work life balance of doctors working in

selected government and private hospitals of Delhi, Jaipur and Lucknow.

G. Collection of data

Primary data: The primary data are those which are collected afresh and for

the first time, and thus happen to be original in character. The primary data is

collected from the sample respondents by Questionnaire method.

Primary data for the study will be collected through:

���� Observation

���� Interview

���� Questionnaire.

The questionnaire consists of four sections:

Section A consists of questions relating to general information.

Section B consists of work life balance scale adapted by Hayman (2005)

originally developed by Fisher (2001). The more inclusive wording of personal

life compared to family provides the opportunity to measure the interface

between work and non work regardless of employee marital or family status.

This broader approach is useful for organizations to assess the non work domain

of employees, as family may not be relevant to all employees. Moreover this

scale also measures positive spill over or enhancement (Hayman, 2005). The

scale consisted of 15 items, designed to assess three dimensions of work life

balance, i.e., work interference with personal life (WIPL-7 items), personal life

interference with work (PLIW-4 items), and work/personal life enhancement

(WPLE-4 items).

24

The first dimension, work interference with personal life (WIPL) included the

items e.g. “Personal life suffers because of work” and “Put personal life on hold

for work”. The content of these items reflect the extent to which work interferes

with personal life. The second dimension is work interference with personal life

(WIPL). The items included in this component indicate the opposite direction of

work personal life interference. Examples of the items include “Personal life

drains me of energy for work” and “Hard to work because of personal matters”.

They depict the extent to which ones’ personal life interferes with work. The

items of the third dimension work/personal life enhancement (WPLE) involved

positive effects of ones’ work on personal life or vice versa, the extent to which

ones’ personal life enhances work. Examples of the items included were,

“Personal life gives me energy for my job” and “Better mood because of my

job”. Five point rating scales is used (1= strongly agree, 5= strongly disagree).

Section C is dedicated to job satisfaction and consists of 15 statements related

to pay, opportunities to develop, patient care, relationship with colleagues,

working conditions, work life balance etc. Five point rating scales is used (1=

strongly agree, 5= strongly disagree).

Section D consists of questions related to provision of various work life balance

programmes provided by the hospitals along with two open ended questions to

determine the view of respondents on work life balance.

Secondary data: The secondary data are those which have already been

collected by someone else and which have already been passed through

statistical process.

Secondary data is collected through published and unpublished sources.

Secondary data for the study will be collected through:

���� Reports

���� Relevant hospitals records.

���� Journals

���� Magazines

���� Newspapers

���� Books

���� e-books

���� e-journals

25

H. Statistical tools

Questionnaire will be distributed and collected personally by visiting different

government and private hospitals. After data is collected it will be processed,

tabulated using Microsoft excel.

For data presentation bar chart, pie chart and tables will be used. Statistical tools

like Chi-square, t-test, Pearson’s correlation, mean, standard deviation,

percentage will be used to analyze the study data using SPSS (Statistical

Package for Social Sciences). Brief description of the tools is given below:

1. Mean, Standard Deviation and Coefficient of Variation: Mean is

calculated by adding a group of numbers and then diving by the count

of those numbers. The standard deviation is just the positive square

root of the variance. Coefficient of variation is used to find the

consistency level between the variables. To categorize the levels of

Work Life Balance and Job Satisfaction, the descriptive statistics,

arithmetic mean and standard deviation can be computed.

2. Independent two-sample t-test: The independent samples t-test is

used when two separate sets of independent and identically distributed

samples are obtained, one from each of the two populations being

compared. To test the sustainability of first and second hypothesis

independent sample t-test can be used.

3. Pearsons Correlation Coefficient: In Bivariate Correlations, the

relationship between two variables is measured. The degree of

relationship could be either positive or negative. The maximum

number could be either +1 (positive) or -1 (negative). This number is

the correlation coefficient. A zero correlation indicates no relationship.

To test the sustainability of third hypothesis Pearsons Correlation

Coefficient can be used.

4. Chi Square test: A Chi Square test is used to see if there is a

relationship between two categorical variables. As a non parametric

test, it can be used to determine if categorical data shows dependency

or the two classifications are independent. To test the sustainability of

fourth hypothesis Chi Square test can be used.

26

Limitations

1. The study is limited to selected government and private hospitals of

Delhi, Jaipur and Lucknow. The findings may not be applicable to the

other parts of country.

2. The view of respondents can be biased; therefore it may not reflect the

true picture.

3. Time and cost will be a major limiting factor.

27

Categorization of Chapters

Chapter 1: Introduction

1.1 : The concept of Work Life Balance

1.2 : Definitions and implications

1.3: Determinants of Work Life Balance

1.4: Work Life Balance- The Indian perspective

1.5: The concept of Job Satisfaction

1.6: Factors affecting Job Satisfaction

Chapter 2: Health sector in India with special reference to Government

and Private Hospitals

2.1: Understanding the Indian Health sector

2.2: Health Infrastructure in India

2.3: Role of government in Indian Health sector

2.4: Types and structure of Hospitals in India

2.5: Overview of Government and Private Hospitals in India

2.6: Condition of Work Life Balance in Indian Hospitals

Chapter 3: Role of Hospitals and Doctors in Public Health with reference

to Delhi, Jaipur and Lucknow

3.1: Overview of the present state of Health services in Delhi,

Jaipur and Lucknow

3.3: Measures taken by government for proper functioning of

Hospitals

3.3: Brief introduction of the Government and Private Hospitals

28

included in the study

Chapter 4: Research Methodology

4.1: Concept of Research Methodology

4.2: Review of Literature

4.3: Objectives of the study

4.4: Hypothesis of the study

4.5: Research Design of the study

4.6: Sample Design of the study

4.7: Scope of the study

4.8: Significance of the study

4.9: Collection of data

4.10: Statistical tools

4.11: Limitations of the study

Chapter 5: Data analysis and interpretation: This chapter will analyse the

responses of the respondents selected for achieving objectives of the research

and establishing hypotheses. The researcher will use chi-square test, t test,

correlation to test the various hypotheses formulated at the beginning of the

study.

Chapter 6: Findings and Suggestions: This chapter presents the summary of

findings along with a conclusion and suggestions based on the findings of the

study.

Bibliography.

Appendices: Questionnaire.

29

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Journal and magazine

� International journal of Business, Management and social sciences.

� Journal of Management and Organization

� Indian Journal of Industrial Relations

� South Asian Journal of Management

� Asian Journal of Multidisciplinary Research

� British Journal of Industrial Relations

� International Journal of Trade

� International Journal of Human Resource Management

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� www.springerlink.com

� www.inflibnet.ac.in

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� www.emeraldinsight.com

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36

Appendices

Respected Sir/Madam,

As a part of my PhD. work I am collecting information and data related to Work Life

Balance and Job Satisfaction of doctors. The study will help the hospitals to plan and promote

various work life balance programs to enhance job satisfaction of doctors and productivity of

the organization.

The questionnaire enclosed consists of four sections:

Section A: General Information

Section B: Scale on Work Life Balance

Section C: Scale on Job Satisfaction

Section D: Work Life Balance Programs

The instructions are provided for responding to the statements/questions. You are

requested to read the instructions carefully and give your response accordingly.

The information collected through this questionnaire will be used only for research

purpose and kept strictly confidential.

I thank you for the co-operation extended in this regard.

Yours Sincerely,

Nivedita Singh,

Research Scholar,

IIS University,

Jaipur.

37

Questionnaire

Section A: General Information

1. Name of the hospital:__________________________-

2. Hospital’s category :

� Public

� Private

3. Respondent’s name :___________________________

4. Job title_____________________________________

5. No. of years of experience:

� 0-5 years

� 6-10 years

� 11-15 years

� 16-20 years

6. Gender:

� Male

� Female

7. Age :

� 25 - 34

� 35 – 44

� 45 – 54

� 55 & older

8. Marital Status :

� Married

� Unmarried

� Others

9. Academic/ Professional Qualification:

� MBBS

� BDS

� MD

� DM

� Others

10. Area of specialization:

� Surgery

� Gastroenterology

38

� Cardiology

� Hematology/Oncology

� Pediatrics

� Neurology

� Others

Section B: Work life Balance

11. Below are given 14 statements related to Work Life Balance. Please put a tick

mark in the column that best describes how much you agree with each

statement below:

1. Strongly disagree, 2. Disagree, 3. Uncertain, 4. Agree, 5. Strongly Agree

SN Statement 1 2 3 4 5

Work interference with personal

life

1. Personal life suffers because of

Hospital work.

2. Job makes personal life difficult.

3. Neglect family needs because of

Hospital work.

4. Put personal life on hold for Hospital

work.

5. Miss personal activities because of

Hospital work.

6. Struggle to juggle work and non-work

7. Happy with the amount of time for non

–work activities.

Personal life interference with work

8. Personal life drains me of energy for

Hospital work.

9. Too tired to be effective at Hospital.

10. My work suffers because of my personal

life

11. Hard to work because of personal

matters.

Work/personal life enhancement

12. Personal life gives me energy for my

job.

13. Job gives me energy to pursue personal

activities.

14. Better mood at Hospital because of

personal life.

15. Better mood because of my Hospital

work.

39

12. In this Hospital doctors can balance their work and private lives. Please tick

mark. Strongly disagree Disagree Neutral Agree Strongly agree

1 2 3 4 5

13. Do any of the following hinder you in balancing your work and life

commitments? Please rank them accordingly:

a) Long working hours

b) Compulsory overtime

c) Shift work

d) Excessive patient load

e) Uncooperative superiors /subordinates

f) Meetings/training after office hours

g) Others, specify__________________________

Section C: Job Satisfaction

14. Below are given 15 statements related to Job Satisfaction. Please put a tick

mark in the column that best describes how much you agree with each

statement below:

1.Strongly disagree, 2. Disagree, 3. Uncertain, 4. Agree, 5. Strongly Agree

S.No Particulars 1 2 3 4 5

1. I have satisfied with the

opportunity I get to develop in

my medical profession.

2. I am satisfied with the authority

I have to make decisions

influencing my patients.

3. I am satisfied with the working

environment available in the

hospital.

4. I am satisfied with my total

hours of work at hospital.

5. I am satisfied with the working

relationship I have with my

colleagues.

6. I am satisfied with the

relationship I have with my

patients.

7. I am satisfied with the quality

of care I provide to my

patients.

8. My work schedule often

conflicts with my personal

time.

9. I am satisfied with my salary.

10. In general I am satisfied with

my work.

40

15. Which of the following factors are of importance for the assessment of your job

satisfaction? Please rank them accordingly:

a) Work content

b) Salary/bonus payment

c) Work life Balance initiatives

d) Colleagues

e) Superior

f) Job Security

g) Career

Section D: Work Life Balance Programmes

16. Does your Hospital provide any provisions for maintaining the work life

balance of doctors?

� Yes

� No

17. If yes, what are the provisions/policies available for maintaining work life

balance of doctors at your Hospital? Please tick mark.

S.NO. Provisions Yes No This would help if

given

1. Flexi-timings(start/end)

2. Job sharing

3. Annual hour system (Fix

number of hours to work over

the year)

4. Career breaks/sabbaticals

5. Carer’s leave (to care of

anyone at home when

required)

6. Maternity leave

7. Crèche facility/child care

8. Employee Assistance Program

9. Employee Wellness Programs

(eg. Yoga, Stress management

workshops etc.)

10. Time off for family event

11. Others ( specify)

18. Are you satisfied with the work life balance programmes provided by the

organization?

� Yes No

41

19. What this organization can do to facilitate you to balance your work and family

life?

Comment:_______________________________________________________

________________________________________________________________

20. Do you think that if doctors have good work life balance the Hospital will be

more effective and successful? Yes/No

If so how?________________________________________________________

________________________________________________________________

Thank You